Suicide and suicidal behavior

Definition

Suicide is the act of deliberately taking one's own life. Suicidal behavior is any deliberate action with potentially life-threatening consequences, such as taking a drug overdose or deliberately crashing a car.

People who attempt suicide are often trying to get away from a life situation that seems impossible to deal with. Many who make a suicide attempt are seeking relief from:

Bad thoughts or feelings

Feeling ashamed, guilty, or like a burden to others

Feeling like a victim

Feelings of rejection, loss, or loneliness

Suicidal behaviors may be triggered by a situation or event that the person views as overwhelming, such as:

Aging (the elderly have the highest rate of suicide)

Death of a loved one

Dependence on alcohol or other drug

Emotional trauma

Serious physical illness

Unemployment or financial problems

Risk factors or triggers for suicide in adolescents include:

Access to firearms

Family member who committed suicide (almost always someone who shared a common mood disorder)

History of deliberate self-harm

History of neglect or abuse

Living in communities where there have been recent outbreaks of suicide in young people

Romantic breakup

Suicide attempts that do not result in death are much more common than completed suicides. Many of these suicide attempts are carried out in a way that makes rescue possible. These attempts often represent a desperate cry for help.

The method of suicide may be somewhat nonviolent, such as poisoning or overdose. Males, especially elderly men, are more likely to choose violent methods, such as shooting themselves. As a result, suicide attempts by males are more likely to be completed.

Relatives of people who seriously attempt or complete suicide often blame themselves or become extremely angry, seeing the attempt or act as selfish. However, when people are suicidal, they often mistakenly believe that they are doing their friends and relatives a favor by taking themselves out of the world. These irrational beliefs often drive their behavior.

Symptoms

Most people who develop thoughts about suicide have already been diagnosed with depression, bipolar disorder, or some other psychiatric disorder. As a result, they may continue to have symptoms, even when they are receiving treatment.

Often, but not always, certain symptoms or behaviors may be present or getting worse before a suicide attempt:

Difficulty concentrating or thinking clearly

Giving away belongings, taking about going away or the need to "get one's affairs in order"

Sudden change in behavior, especially calmness after a period of anxiety

Loss of interest in activities that were previously enjoyable

Performing self-destructive behaviors, such as drinking alcohol, using illegal drugs, or cutting

Sudden difficulty in school or work performance

Talking about death or suicide, or even stating the desire to harm themselves

Talking about feeling hopeless or guilty

Unusual changes in sleep or eating habits

Withdrawal from friends or an unwillingness to go out anywhere

Signs and tests

Support Groups

Expectations (prognosis)

Suicide attempts and threats should always be taken seriously. About one-third of people who attempt suicide will repeat the attempt within 1 year, and about 10% of those who threaten or attempt suicide eventually do kill themselves.

Mental health care should be sought immediately. Dismissing the person's behavior as attention-seeking can have devastating consequences.

Calling your health care provider

Call a health care provider right away if you notice one or more suicide warning signs.

Complications

Complications vary depending on the type of suicide attempt.

Treatments

A person may need emergency measures after attempting suicide. First aid, CPR, or mouth-to-mouth resuscitation may be needed.

Hospitalization is often needed to treat a suicide attempt and to prevent future attempts. Mental health intervention is one of the most important aspects of treatment.

After suicidal behavior is addressed, any underlying disorders should be treated (such as major depression, bipolar disorder, or alcohol dependence).

Adolescents may fail to seek help for suicidal thoughts, for all of the following reasons:

They believe nothing will help

They are reluctant to tell anyone they have problems

They think it is a sign of weakness to seek help

They do not know where to go for help

There are numbers that you can call from anywhere in the United States, 24 hours a day, 7 days a week: 1-800-SUICIDE or 1-800-999-9999.

Prevention

Avoiding alcohol, narcotics, sedatives that have not been prescribed, and illegal drugs can help prevent suicide. These substances affect the brain and can make the depression worse over time.

In homes with adolescents:

All prescription medicines should be kept secure.

Do not keep alcohol in the home, or keep it locked up.

Securely lock all guns and keep the ammunition separate.

Many people who attempt suicide talk about it before making the attempt. Sometimes, simply talking to a sympathetic, nonjudgmental listener is enough to prevent the person from attempting suicide. For this reason suicide prevention centers have telephone "hotline" services. Again, do not ignore a suicide threat or attempted suicide.

As with any other type of emergency, it is best to immediately call the local emergency number (such as 911). Do not leave the person alone even after phone contact with an appropriate professional has been made.

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